PRESCRIPTION FOR ADDICTION; OxyContin Boom: Side Effects May Include Drug Habit, Crime

By LAURA CRIMALDI

Bay State doctors are prescribing oxycodone painkillers at a record pace, alarming health officials as they roll out a $400,000 state ad blitz warning kids of the drug’s deadly addictive threat, the Herald has learned.

The number of prescriptions for oxycodone products, including OxyContin, Percocet and Tylox, has skyrocketed by almost 50 percent in five years, from a little over 1 million in fiscal year 2000 to nearly 1.5 million in fiscal year 2005, according to statistics from the state Prescription Monitoring Program.

“We’re now misusing these pharmaceuticals and it’s tearing apart lives. The more you prescribe, the more addiction you will breed,” said state Rep. Peter Koutoujian (D-Watertown), who is chairman of the Legislature’s OxyContin Commission.

This week, the state Department of Public Health will roll out radio and transit ads discouraging teens from abusing OxyContin and other prescription drugs.

Oxycodone prescriptions are rising amid two polarizing trends: an OxyContin-abuse epidemic fueling a black market on one hand, and intensifying pressure on health professionals to improve pain treatment on the other.

The picture of opiate addiction statewide is bleak. From 1990 to 2003, the number of opiate-related deaths soared from 94 to 574, according to Michael Botticelli, assistant commissioner for substance-abuse services at the state Department of Public Health. From 1999 to 2002, the number of hospital visits related to opiate use rose by 134 percent, he said.

Addicts resort to desperate measures to get their hands on the powerful painkillers by “doctor shopping” for a prescription or buying it on the black market for as much as $80 a pill. Last summer, the Board of Registration in Medicine suspended the license of Dr. Michael Brown, a Sandwich internist nicknamed “Dr. Feel Good,” who had been accused of grossly overprescribing OxyContin.

“There are doctors out there who will prescribe it without investigating the person saying they are in pain,” said Joanne Peterson, founder of Learn2Cope, a support group for parents whose children are addicted to heroin and OxyContin.

However, health-care professionals say they face tremendous pressure from oversight agencies, including the Joint Commission on Accreditation of Healthcare Organizations, to do a better job of treating pain.

As lawsuits pile up from plaintiffs who either got hooked or claim doctors did not do enough to treat their pain, doctors and nurses are snared in a Catch-22.

“There’s too much polarization based on emotion and fear,” said Tom Quinn, a nurse at Massachusetts General Hospital and project director for the MGH Cares About Pain Relief program. “It’s our responsibility to know about the laws and the risk, but it’s also our responsibility to treat our patients. There are some people out there who have not even gotten a DEA license to prescribe opiates because of that fear and that, in my opinion, borders on the unethical.”

Dr. James Otis of the Pain Management Group at Boston Medical Center said new MassHealth rules requiring prior authorization for certain daily dosages of methadone and morphine may account for the increase in oxycodone prescriptions.

But Dr. P.S. Kishore, addiction specialist and founder of the National Library of Addictions in Brookline, said there must be more oversight of painkiller prescriptions.

“For a small state like us, that’s a pretty hefty amount of prescriptions. That’s a fair amount of pain,” Kishore said, referring to the nearly 1.5 million pain scripts – one for every four Bay State residents. “Where are all these extra prescriptions coming from? Where is the pain burden coming from?”